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Old 04-06-11, 10:50 AM   #27
Bilge_Rat
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I will make one serious comment. One of the proposed solution to the medicare/medicaid issue is to transfer responsibility to the individual states and have the federal government make lump sum payments, with limited future increases presumably capped to cost of living. Unstated, but presumably under the premise that individual states could administer Medicare/Medicaid at a lower cost by tailoring the system to local conditions.

This solution is what was implemented in Canada 30 years ago. In the late 70s, the can. federal govt. was facing ballooning deficits. At the time, the fed. govt was funding 50% of public health care and many other social programs and the other 50% was paid by the provinces. They came up with a similar plan where the responsibility for the programs would be transferred to the individual provinces and the fed. govt would only pay a lump sum annual payment, increased each year by a cost of living increase.

Well, it turned out to be a great plan for the federal government. Over the past 30 years, the federal share of health care spending has gone down from 50% to around 30% while the provinces now pay around 70%. The federal govt, up until 2008 was running surpluses while the provinces have chronic deficits and the political problem of trying to figure out what programs to cut or what taxes to raise.

So the GOP solution sounds fine on paper, but all you wind up doing is transferring the problem to the individual states.
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